Today's Veterinary Practice

JAN-FEB 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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PEER REVIEWED 86 IMAGING ESSENTIALS Canine and feline gastrointestinal wall thicknesses vary depending on the segment assessed ( TABLE 1 ). Stomach The normal canine and feline stomach is located caudal to the liver. The different portions of the stomach include the cardia, fundus, body, and pyloric antrum, leading into the pyloroduodenal junction (pyloric sphincter). In most cases, the cardia is not identified due to its cranial location and interposition of the liver, although, occasionally, it can be identified through dorsal intercostal acoustic windows. The fundus, located in the left cranial abdominal cavity, is scanned in longitudinal and transverse axes. Next, the transducer is moved medially towards midline to scan the body of the stomach. In the feline patient, the body of the stomach can be found on the left of midline; the canine gastric body can be located right of midline if ingesta, gas, and/or fluid are present within the lumen of the stomach ( FIGURE 4 ). The pyloric sphincter can be recognized due to its hyperechoic mucosa in contrast to the pyloric antral mucosa and duodenal mucosa, which are hypoechoic. The transverse section of the empty feline stomach has a characteristic wagon wheel appearance, often with a thick, hyperechoic submucosal layer due to fat deposition ( FIGURE 5 ). Duodenum and Jejunum The duodenum in the dog is the thickest segment of the small intestinal tract and contains the thickest FIGURE 4. Longitudinal axis view of the stomach of a normal dog with a gas filled stomach. Note the hyperechoic gas interface ( white arrow ) with distal reverberation artifact and dirty shadowing; the lack of rugal folds within the gastric lumen is due to distension of the lumen with gas. TABLE 1 Normal Ultrasonographic Measurements (95% Confidence Intervals) of Gastrointestinal Tract Wall Thickness in Dogs and Cats SEGMENT OF GASTROINTESTINAL TRACT DOG WALL THICKNESS CAT WALL THICKNESS Stomach 3 − 5 mm 2 2 mm (inter-rugal) 3,4 and 4 mm (rugal fold thickness) 3 Duodenum Up to 5 mm 5 2 − 2.5 mm 6,7 Jejunum 2 − 5 mm 6 2 − 2.5 mm 6,7 Ileum 2 − 4 mm 6 2.5 − 3.2 mm 4,6,7 Colon 2 − 3 mm 6 1.4 − 2.5 mm 6 Cecum 1.5 mm 8 1.5 − 2 mm 8-10 Note: Normal ultrasonographic measurements of the individual layers of the canine 11 and feline 7,12 gastrointestinal tract have been described in recent literature. BOX 1 Criteria for assessing the small intestines include: Uniformity in diameter Wall thickness ( TABLE 1 ) Discrete wall layering Presence of luminal contents Peristalsis

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